Detection of high risk pregnancies with relation to ABO haemolytic disease of newborn

IgM and IgG anti A and anti B antibody status of 100 antenatal O group mothers (who had non O group husbands) were studied. Of these, 3 mothers had an IgM anti A antibody levels ranging from 1 : 512 to 1 : 2048 and IgG ranging from 1 : 1204 to 1 : 2048, IgM anti B ranging from 1 : 128 to 1 : 512 and IgG anti B ranging from 1 : 256 to 1 : 512. All these mothers had A + ve children and all these children suffered from ABO haemolytic disease of newborn (HDN). A 4th mother had an IgM anti A titre of 1 : 64 and IgG anti A titre of 1 :16. The titre of IgM anti B in this mother was 1 : 512 and that of IgG 1 : 1024. The child was A + ve and did not suffer from ABO haemolytic disease of newborn.     

Brainstem auditory evoked response in newborns with hyperbilirubinemia

OBJECTIVE: To determine the initial Brainstem Auditory Evoked Response (BAER) abnormalities in neonates with hyperbilirubinemia and the possible reversibility of abnormal BAER after therapy. DESIGN: Prospective cohort study. SETTING: Tertiary care hospital. SUBJECTS: 30 term neonates with hyperbilirubinemia (S. bilirubin < 15 mg/dl) as cases and 25 normal term neonates as controls. METHODS: Duration of study was from August 1995 to August 1996. BAER were recorded before therapy at peak hyperbilirubinemia, after therapy, and the age of 2-4 months using electric response audiometer (Nihon Neuropack Four Machine). Denver Development Screening Test (Denver II) was performed at 1 year of age. RESULTS: Seventeen out of thirty (56.7%) neonates with hyperbilirubinemia showed abnormalities on initial BAER. Commonest abnormality seen was raised threshold of wave V in 12 neonates (40%). Other abnormalities observed were absence of all waves at 90 dB (23.3%), prolongation of latencies of various waves (26.7%) and prolongation of various intervals (26.7%). Abnormalities in BAER correlated significantly with bilirubin level. After therapy abnormalities reverted back to normal in 10 cases but persisted in 7 out of 17 (41.17%) cases with initial abnormal BAER. Development screening at 1 yr was abnormal in 3 infants all of whom had persistent abnormalities in BAER. CONCLUSION: Serial BAER is a useful, non invasive tool to detect neurodevelopment delay secondary to neonatal hyperbilirubinemia.     

Comparison of the antihypertensive effects of carvedilol and metoprolol on resting and exercise blood pressure

The present study was conducted to assess the efficacy and safety of carvedilol 50 mg as compared to metoprolol 200 mg at rest and during and after a standardized bicycle ergometric exercise test. Carvedilol is a novel non-selective -blocker without intrinsic sympathomimetic activity possessing vasodilatory properties primarily due to an ₁-antagonism in the same dose range. Both drugs were effective in reducing systolic and diastolic blood pressure at rest and during and after exercise. The reduction of diastolic blood pressure was much stronger under carvedilol treatment than under metoprolol treatment at all measurement points. Carvedilol was even effective in the treatment of patients whose blood pressure was unsatisfactorily controlled by metoprolol. This shows the importance of the vasodilation component of carvedilol. No serious adverse events were observed. Carvedilol therefore promises very well as a powerful and safe drug for the treatment of essential arterial hypertension.